In six-year period, 49,000 vets took their own lives

Editor’s note: Few issues are as important to our state and nation as the treatment of our veterans. That’s why the Maine Center for Public Interest Reporting is taking the unusual step of distributing and prominently featuring the work of another journalism group, NEWS21. Its groundbreaking series on veterans called, “Back Home: The Challenges Facing Post-9/11 Veterans Returning from the Wars in Iraq and Afghanistan,” comes to the Center through our membership in the Investigative News Network.

Major portions of the series will be running on our web site, Pinetreewatchdog.org, over the next week. We are also linking to the full series on News21.com.

News21 is a national initiative to train a new generation of journalists capable of reshaping the news industry. The program is headquartered at the Walter Cronkite School of Journalism and Mass Communication at Arizona State University. Nearly 500 top journalism students in the U.S. have participated in the landmark national initiative under the direction of nationally recognized professional journalists, including two Pulitzer Prize winners. – John Christie, publisher

Veterans are killing themselves at more than double the rate of the civilian population with about 49,000 taking their own lives between 2005 and 2011, according to data collected over eight months by News21.

Tracking Veteran Suicides

Click image to view interactive chart

Records from 48 states show the annual suicide rate among veterans is about 30 for every 100,000 of the population, compared to a civilian rate of about 14 per 100,000. The suicide rate among veterans increased an average 2.6 percent a year from 2005 to 2011, or more than double that of the 1.1 percent civilian rate, according to News21’s analysis of states’ mortality data.

Nearly one in every five suicides nationally is a veteran — 18 to 20 percent annually — compared with Census data that shows veterans make up about 10 percent of the U.S. adult population.

“Anytime a veteran who fought our enemies abroad or helped defend America from within our borders dies by their own hand, it’s completely unacceptable,” Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veteran’s Affairs, told an American Legion conference in Washington earlier this year. The suicide rate has remained consistently high, he said, adding that more work was needed to address gaps in veterans’ mental health care.

A 2007 law required the Department of Veterans Affairs to increase its suicide prevention efforts. In response to the Joshua Omvig Veteran Suicide Prevention Act — named for an Iraq war veteran who committed suicide in 2005 — the department’s efforts include educating the public about suicide risk factors, providing additional mental health resources for veterans and tracking veteran suicides in each state. The VA’s mental health care staff and budget have grown by nearly 40 percent over the last six years and more veterans are seeking mental health treatment.

The law mandated that the VA design a comprehensive program to reduce veteran suicides. Provisions included training VA staff in suicide-prevention techniques, factoring mental health concerns in overall veteran health assessments, providing referrals at veterans’ request to treatment programs and designating suicide-prevention counselors at VA medical centers. It also required the VA to work with the other federal departments on researching the “best practices” for preventing suicides.

VA efforts since 2007 have shown some results. The Veterans Crisis Line — a national phone line — has experienced a steady increase in the number of calls, texts and chat session visits from former soldiers struggling with suicidal thoughts. In 2007, its first year, 9,379 calls went to the crisis line. Each year the call volume has increased, reaching a high of 193,507 calls in 2012, totaling about 840,000 overall, according to the VA.

“It’s discouraging to keep looking at the (suicide) rates, and we have to keep plugging away,” said Dr. Jan Kemp, the VA national suicide-prevention coordinator, and program manager of the crisis line. But she said without resources such as the crisis line “the rates would be higher.”

The VA is analyzing mortality data collected from states and Department of Defense records to try to understand veteran suicides. The task has been “almost impossible” until recent years, Kemp said, because the federal Centers for Disease Control and Prevention does not track veteran deaths and most veterans are not enrolled in the VA system.

News21 sought data on post-9/11 veteran suicides, but state statistics rarely included identifying information or detailed service records. However, a 2012 report from Substance Abuse and Mental Health Services Administration (SAMHSA) showed that between 2002 and 2005, 144 veterans of post-9/11 wars committed suicide out of total veteran population of 490,346. In 2009, 98 men and women from post-9/11 wars took their own lives, according to that same report.

A plurality of veteran suicides has been among those 65 or older, according to the data. About 19 percent of suicides that took place between 2005 and 2011 were veterans between 18 and 44 years old, among the 36 states with available age data. It is important to reach post-9/11 veterans early, Kemp said, to help mitigate a potential increase in suicides as veterans approach those vulnerable ages.

“Maybe we can change that trajectory,” she said.

War can exact a heavy toll on the mental health of soldiers, but veterans have the same risk factors for suicide as the general population, said Craig Bryan, research director at the University of Utah National Center for Veterans Studies. Those factors include feelings of depression, hopelessness, post-traumatic stress disorder, a history of trauma and access to firearms.

“Veterans who die by suicide look a lot like Americans who die by suicide,” Kemp said.

Veterans experience periods of readjustment as they reintegrate into civilian life. Traits and training needed to survive in a war zone — like maintaining constant alertness — might contribute to troubling behaviors in civilian life, including edgy feelings while being easily startled, according to the SAMHSA report. Suicide warning signs including feelings of being hopeless, out of control, angry or trapped. Combat veterans might experience a variety of stress reactions including nightmares, sleeplessness, sadness, feelings of rejection, abandonment or hopelessness. Lack of concentration, aggressive behavior, reckless driving, and increasing use of alcohol, tobacco and drugs are other common struggles.

Clinton Hall, 35, lives in Portland, Ore., working as a supply-chain analyst. He served in Iraq and Afghanistan as an Army specialist and was discharged in 2007. One of his close friends, who also was a veteran, committed suicide upon coming home.

“The bad part about it is that he didn’t give us a chance to talk. I mean, if he had just said, ‘Hey, Clint I’m thinking about doing this.’ I could have said, hey man, I’m thinking about doing it too. You got to have that conversation. You have to tell somebody, as embarrassing as it is,” he said. “All I ever considered when I thought about (suicide) was the guilt I was feeling and just wanting a way out, wanting to not have those memories anymore.”

Concussions also are a chronic risk factor leading to suicidal thoughts, Bryan said, because head trauma makes people more vulnerable to suicidal thoughts. The dangerous daily routines of a soldier — or simply involvement in sports or accidents — increase the risk of injury.

“It turns up the volume on depression,” he said.

In 2010, Veterans Affairs Secretary Eric Shinseki asked governors to collaborate on collecting veterans’ suicides information in their states. Through November 2012, according the VA report, 34 states had submitted data and agreements had been forged with eight others to provide information.

News21 filed a Freedom of Information Act request for the raw data collected by the VA to this point, but it was denied because the “disclosure of raw research data poses a serious threat to the scientific process” and because of fears the information would be misinterpreted without peer review.

Most states provided veteran suicide information gleaned from death certificates. VA research, Kemp said, shows death certificates are about 90 percent accurate and “good enough” to help understand veteran suicides.

Veterans are over-represented among suicides compared to the general population, a trend seen in most states between 2005 and 2011.

For example, in Alaska, veterans were about 14 percent of the population, but represented about 21 percent of all suicides in 2010. The same year in Washington, Census data showed veterans were about 11 percent of the population, but state vital statistics showed they represented about 23 percent of suicides.

Suicide rates within the veteran population often were double and sometimes triple the civilian suicide rate in several states. Arizona’s 2011 veteran suicide rate was 43.9 per 100,000 people, nearly tripling the civilian suicide rate of 14.4, according to the latest numbers from the state health department.

Among states with the widest disparities and highest rates, Idaho had an average annual veteran suicide rate of 49.5 per 100,000 people, according to News21 analysis, compared to a civilian rate of 20 per 100,000. Montana had an average annual veteran suicide rate of 55.9 per 100,000 people and a 23.9 civilian rate.

New Jersey had among the lowest annual veteran suicide rates across the time period, with 17.2 dying by suicide per 100,000 people and a civilian rate of 8.6 Connecticut had a veteran suicide rate of 20.11 per 100,000 people and a civilian rate of 11.

Massachusetts had the smallest disparity and one of the lowest rates, according to the data, with an average annual veteran suicide rate of 12.3 and a civilian rate of 10.3.

About 26 percent of suicides in Oregon were among veterans, with 96 percent of them being male, according to a November 2012 study by the state’s human services department. New21 analysis showed that 24 percent of all Oregon suicides annually were veterans.

As with suicides in general, veterans taking their own lives have been overwhelmingly male — about 97 percent among the 30 states that reported gender demographics. While suicide has traditionally been a problem among white males, it underscores the suicide risks faced by the U.S. veteran population.

In June, the VA hired 1,600 clinicians to assist with mental health counseling for veterans in compliance an executive order last year from President Barack Obama. This is only part of the solution, Utah researcher Bryan said, because “veterans don’t come to mental health treatment.”

The challenge is understanding suicide in the general population, Bryan said, and then translating those factors for the military and veterans, who are part of a “unique subculture” in the U.S.

“(Veterans) have different rules and different expectations and ways of seeing themselves” and their roles in society, he said. “What we see in society doesn’t always translate as well into the military.”

Part of that culture is mental toughness, he said, along with “elitism” and “feelings of superiority,” mindsets that render traditional suicide prevention methods less effective. “They are very much like elite athletes,” he said of those least likely to complain of pain or injury.

Hall, who was diagnosed with PTSD following his return home, had a message for veterans who might struggle — as he did — with suicidal thoughts:

“Talk to anybody. If you’ve got a number or an email address for your battle buddies, reach out to them. Chances are, they’re feeling the same way you do. If you don’t have anybody to talk to, call the VA. Call the suicide prevention hotline. Hell, if you can find me on Google, contact me and we’ll talk. But don’t do it (commit suicide). I’m thinking about it too, I know other people are too. But don’t do it.”

The Veterans Crisis Line can be reached online or by calling 800-273-8255.

Gallery

A memorial for Raymond Matthew Burke, shown here, was placed on the George Washington University Yard June 2 in Washington, D.C. Burke's mother, Mary Anne Burke, and his father, Raymond Burke, participated in the 16-mile Out of the Darkness Overnight Walk in memory of their son and to raise money and awareness, and to help prevent suicide. Raymond Matthew Burke died only months before his first deployment on a submarine.
Photo by Chase Cook/News21

Mary Anne Burke holds her son's dog tag after completing a 16-mile walk throughout downtown Washington, D.C. Burke's son, Raymond Matthew Burke, died by suicide in 2001 while he was on leave from his naval station. Mary Ann Burke and her husband, Raymond Burke, have participated in every Out of the Darkness Overnight Walk and plan to complete two more walks next year.
Photo by Chase Cook/News21

Participants who completed the walk watch the closing ceremony on the George Washington University Yard, June 2 in Washington, D.C. This year’s walk raised more than $2.6 million for suicide awareness and prevention.
Photo by Chase Cook/News21

Memorials to those lost to suicide border the walkways of the George Washington University Yard, striding between the luminaries are walkers who completed the 16-mile route. About 2,000 illuminated memorials were placed on the lawn and many walkers examined the memorials as they waited for the closing ceremony to begin.
Photo by Chase Cook/News21

Walkers passed in front of the White House between 11 p.m. and midnight. Some walkers stopped to take photos while others pushed on through downtown Washington, D.C. The White House represented about the 10-mile mark. The red lights seen in the photo are the armbands participants wore as identification and safety during the walk.
Photo by Chase Cook/News21

Walkers pass the Lincoln Memorial in Washington, D.C. The event took the group to several historic locations such as the Washington Monument, Jefferson Memorial and the Library of Congress. Rest stops were featured along the route as well to keep walkers hydrated and energized.
Photo by Chase Cook/News21

Participants in the walk flow out of the George Washington University Yard as they begin their 16-mile trek through downtown Washington, D.C. With about 1,700 walkers, it took about 15 minutes for the group to begin their journey. Walkers wore T-shirts and armbands that flashed to identify them as participants in the overnight walk.
Photo by Chase Cook/News21

Pam Heir lays white beads on a memorial for her son, Amar Heir, who died of suicide in 2011. Participants in the Out of the Darkness Overnight Walk wore varying colors of beads as they trekked 16 miles to raise awareness and help prevent suicide. The white honor beads symbolized the loss of a child.
Photo by Chase Cook/News21

Army Reservist Thomas Sweet, 29, is introduced as a representative of the men and women in the military who have died by suicide. An estimated 22 veterans die by suicide a day, and in 2012 the number of active duty military dying by suicide surpassed combat deaths in Afghanistan, according to the Department of Defense.
Photo by Chase Cook/News21

About 1,700 participants stretch to Zumba music before the Out of the Darkness Overnight Walk in Washington, D.C. June 1. The American Foundation for Suicide Prevention holds the annual walk to raise money for suicide awareness and prevention. About 2,000 walkers and volunteers participated this year.
Photo by Chase Cook/News21

Bonnie Campo and and Chase Cook were Ethics and Excellence in Journalism Foundation Fellows for News21 this summer.

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